Abstract
BackgroundLocomotion involves an integration of vision, proprioception, and vestibular information. The parieto-insular vestibular cortex is known to affect the supra-spinal rhythm generators, and the vestibular system regulates anti-gravity muscle tone of the lower leg in the same side to maintain an upright posture through the extra-pyramidal track. To demonstrate the relationship between locomotion and vestibular function, we evaluated the differences in gait patterns between vestibular neuritis (VN) patients and normal subjects using a gyroscope sensor and long-way walking protocol.MethodsGyroscope sensors were attached to both shanks of healthy controls (n=10) and age-matched VN patients (n = 10). We then asked the participants to walk 88.8 m along a corridor. Through the summation of gait cycle data, we measured gait frequency (Hz), normalized angular velocity (NAV) of each axis for legs, maximum and minimum NAV, up-slope and down-slope of NAV in swing phase, stride-swing-stance time (s), and stance to stride ratio (%).ResultsThe most dominant walking frequency in the VN group was not different compared to normal control. The NAVs of z-axis (pitch motion) were significantly larger than the others (x-, y-axis) and the values in VN patients tended to decrease in both legs and the difference of NAV between both group was significant in the ipsi-lesion side in the VN group only (p=0.03). Additionally, the gait velocity of these individuals was decreased relatively to controls (1.11 ± 0.120 and 0.84 ± 0.061 m/s in control and VN group respectively, p<0.01), which seems to be related to the significantly increased stance and stride time of the ipsi-lesion side. Moreover, in the VN group, the maximum NAV of the lesion side was less, and the minimum one was higher than control group. Furthermore, the down-slope and up-slope of NAV decreased on the impaired side.ConclusionThe walking pattern of VN patients was highly phase-dependent, and NAV of pitch motion was significantly decreased in the ipsi-lesion side. The change of gait rhythm, stance and stride time, and maximum/minimum NAV of the ipsi-lesion side were characteristics of individuals with VN.
Highlights
Locomotion involves an integration of vision, proprioception, and vestibular information
The first dominant frequencies (f1) of gait cycle in lesion side of vestibular neuritis (VN) patients were observed at 0.94 ± 0.111 Hz and the second dominant frequency (f2) was ambiguous and higher in the VN patients (3.4 ± 1.627, p < 0.001) than the normal control (Figure 3)
Borel et al have reported that changes in gait pattern after unilateral vestibular neurotomy (UVN) are characterized by slower gait compared to controls, and the slow gait after UVN is mainly due to step length and step frequency reductions, for both open- and closed- eye conditions, and locomotion speeds
Summary
Locomotion involves an integration of vision, proprioception, and vestibular information. Appropriate body motion in space during locomotion depends on the integration of vision, proprioception, and vestibular information [3] These afferent sensory feedback signals related to locomotion play a crucial role in adapting and modulating the operation of the locomotor network in the real environment [4]. To reliably assess gait variability and evaluate human motor performance, it has been recommended to collect over 10 to hundreds continuous stride in order to avoid the limitations of conventional gait protocols, and to get measuring variability [21,29,30] To overcome this obstacle, simplified testing devices, such as gyroscope sensors and accelerometers, have been introduced for objective gait analyses [31,32]. There was not any report the result of gait pattern analysis in patients with vestibular disorder using long way walking protocol yet
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